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Feng Shui House Care Home Good

Reports


Inspection carried out on 3 October 2019

During a routine inspection

About the service

Feng Shui House Care Home is a residential care home providing personal care to 18 people aged 65 and over at the time of the inspection. The service is registered to support up to 20 people.

People’s experience of using this service and what we found

Medicines were administered safely; however good practice guidelines were not always followed. We have made a recommendation about the management of some medicines.

All other risks people faced were assessed and safely managed. People and relatives felt the care and support kept people safe. Staff showed good knowledge of safeguarding procedures. Infection prevention was ongoing, and the home was clean and well maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. We have made a recommendation the service work within the principles of the Mental Capacity Act 2005 (MCA).

The provider had links with health professionals. This promoted timely support and positive outcomes for people. People had access to food and drinks, 24 hours a day if requested. Staff told us the training ensured they had the skills to carry out their roles effectively and the management team were supportive.

Care plans did not always contain comprehensive information on people’s unique support needs. We have made a recommendation about this.

The management team audited the service to ensure people received effective support and the service was well-led. We have made a recommendation about audits.

The provider representative used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.

People took part in valued activities within the home. The provider representative would deliver end of life care to ensure people stayed in a familiar environment with people they knew. People’s communication needs were identified, and appropriate support offered. There was a complaints procedure which was made available to people and their families.

Staff were knowledgeable about people’s backgrounds and preferences. They were caring, patient and took time to ensure people felt valued. They worked in partnership with people, offered choices and promoted people’s independence. Due to the stability of the staff team there was a rapport between people, visitors and staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 October 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 13 September 2018

During a routine inspection

Feng Shui House Care Home was inspected on the 13 and 17 September 2018 and the first day of the inspection was unannounced.

Feng Shui House Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Feng Shui House Care Home is registered to provide personal care for up to 20 older people who require support with personal care. At the time of the inspection there were 16 people receiving support.

The home is located in the seaside resort of Blackpool overlooking the south promenade.

At our last inspection in April 2016 the service was rated ‘Good.’ At this inspection we found notifications that are required to be sent to the Care Quality Commission when certain events occur, were not always provided to us. This was a breach of Regulation 18 of the Care Quality Commission (Registration Regulations) 2009.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

You can see the action we told the provider to take in the full version of the report.

We observed medicines being administered and saw this was carried out in a safe way. Access to medicines was restricted to staff who had received training to ensure medicines were administered and managed safely. We noted a recording error within the services ‘Controlled drugs’ book. Prior to the inspection being concluded we saw the error had been rectified. We have made a recommendation about the safe management of medicines.

Recruitment checks were carried out to ensure suitable people were employed to work at the service and staff told us they were supported to attend training to maintain and increase their skills. We saw one staff record where no reason had been recorded for a gap in employment. We have made a recommendation regarding the recording of prospective staff information.

We found some information was recorded regarding people’s end of life wishes and the deputy manager told us they were planning to review this area of people’s care. We have made a recommendation regarding end of life care planning.

The registered provider told us there were two deputy managers in place and they completed checks to identify if improvements were required in the service provided. We saw documentation which showed checks were carried out and staff told us they were informed if improvements were required.

The home had an electronic care record system. Care records contained information regarding risks and guidance for staff on how risks were to be managed. We found one care record required updating as further information was required regarding how a person’s change in needs could be met. Prior to the inspection concluding we were informed this had been done.

Staff we spoke with knew the needs and wishes of people who lived at the home. Staff spoke fondly of the people they supported and said they cared about them and their wellbeing. Staff were gentle and patient with people who lived at the home and people told us they felt respected and valued.

Relatives told us they were consulted and involved in their family members care. People we spoke with confirmed they were involved in their care planning if they wished to be and staff treated them kindly and with respect.

Staff we spoke with were able to describe the help and support people required to maintain their safety and people who lived at the home told us they felt safe.

People told us they had access to healthcare professionals and their healthcare needs were met. Documentation we viewed showed people were supported to access further healthcare advice if this was appropriate

Inspection carried out on 8 March 2016

During a routine inspection

We carried out an unannounced comprehensive inspection of this service on 12 March 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

During our inspection undertaken on 08 March 2016 we found no breaches of legal requirements.

Feng Shui House Care Home is registered for the regulated activity accommodation for persons who require nursing or personal care for 20 people. The home is located in the seaside resort of Blackpool overlooking the south promenade. All bedrooms have en suite facilities. A hairdressing salon and therapy room is also in place for the use of people staying at the home. Off street parking is available for visitors. At the time of our inspection visit there were 19 people who lived at the home.

The registered provider was an individual who also managed the home on a day to day basis. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed they had received induction training when they commenced working at the home. One staff member said, “I had to wait for my references and Disclosure and Barring Service checks (DBS) to be completed before I could start working at the home. I understand these checks are required to ensure I do not have a criminal record.”

Staff had received training and were knowledgeable about their roles and responsibilities. They had skills, knowledge and experience required to support people with their care and social needs.

We found sufficient staffing levels were in place to provide support people required. We saw staff could undertake tasks supporting people without feeling rushed. People told us when they requested assistance this was responded to in a timely manner. One person said, “I have my alarm with me at all times and know staff will come running if I press it. This makes me feel safe.”

We found the registered provider had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.

The registered provider understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

We looked around the home and found it was clean, tidy and well-maintained. No offensive odours were observed by the inspection team. We observed staff making appropriate use of personal protective equipment such as disposable gloves and aprons. This meant staff were protected from potential infection when delivering personal care and undertaking cleaning duties. People who lived at the home told us they were happy with the standard of hygiene in place.

Equipment used by staff to support people had been maintained and serviced to ensure they were safe for use.

We found care plans were organised and had identified the care and support people required. We saw people or a family member had been involved in the assessment and had consented to support provided. We found care plans were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs. People we spoke with said they were happy with their care and they liked living at the home.

Risk assessments had been developed to minimise the potential risk of harm to people during

Inspection carried out on 12 March 2015

During a routine inspection

Feng Shui Care Home provides care and support for a maximum of 20 people. At the time of our visit the home was full although two people were in hospital. Seven people at the home had a formal diagnosis of dementia. The home is located in the seaside resort of Blackpool overlooking the South promenade. All bedrooms have en-suite facilities. A hairdressing and therapy room is also in place for the use of people staying in the home. A large lounge and dining area is on the ground floor with a smaller lounge located on the first floor. A passenger lift is provided to ensure freedom of movement so people living at Feng Shui have access to all areas of the home.

We last inspected Feng Shui Care Home on 30 July 2014, and the home was found to be in breach of regulation 13 of the Health and Social Care Act 2008, Management of Medicines and regulation 21, Requirements relating to workers. An action plan was received following the inspection along with further supporting information stating that all the breaches had been dealt with by the provider. As part of this inspection we looked at each regulation breach to ensure the actions stated within this information had been carried out.

This inspection took place on the 3 March 2015 and was unannounced.

There was a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was also the proprietor of the home.

People told us they felt safe at the home and with the staff who supported them. One person told us, “I feel very well cared for as they are so kind and they are not just putting it on for you, they are wonderful. I enjoy it here, the food is great and so is the atmosphere. It’s a belting place and I’ve no complaints at all.”

Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. We did however see several incidents within people’s daily notes that should have been referred as safeguarding incidents through to the local authority. The registered manager informed us that the incidents had been reported through to the Local Authority via telephone conversations however no evidence of the calls could be provided. The Local Authority for the home use a web portal system as its preferred method so an audit trail is in place and referrals into the system can be evidenced.

During the inspection we saw staffing levels were sufficient to provide a good level of care. People we spoke with confirmed this was always the case.

People were not protected against the risks associated with medicines. This was because adequate stocks of medicines were not maintained to allow continuity of treatment. Suitable arrangements were not in place for ordering medicines needed outside the main monthly delivery. Three of the eight records we looked at showed that people had missed doses of one of their regular medicines for between four and seven days. Audits of medicines handling and staff competency assessments had not yet been completed by managers at the home, to ensure medicines were consistently safely handled in accordance with the home’s policy. We have made a recommendation about this.

During our visit, we spent time in all areas of the home. This helped us to observe the daily routines and gain an insight into how people's care and support was managed. People were relaxed and comfortable with staff and it was evident that members of staff knew the people they were caring for well.

We looked at people’s care records to see if their needs were assessed and consistently met. Care records were written well and contained good detail. Outcomes for people were recorded and actions noted to assist people to achieve their goals. However some elements of people’s care plans used standardised text which appeared throughout each of the five care plans we looked at. There was also little detail of people’s life histories within people’s care plans. We have made a recommendation about this.

People we spoke with and visiting relatives told us they knew how to raise issues or make complaints. They also told us they felt confident that any issues raised would be listened to and addressed.

Observations of how the registered manager interacted with staff members and comments from staff showed us the service had a positive culture that was centred on the individual people they supported. We found the service was well-led, with clear lines of responsibility and accountability.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to arrangements for safeguarding people who use services from abuse.

This breach also amount to breaches of the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 30 July 2014

During a routine inspection

The inspection team was made up of two Inspectors and a Care Quality Commission (CQC) Pharmacist. During the inspection the team gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. We also spoke with Blackpool council�s contracts monitoring team and Healthwatch Blackpool who are an independent consumer champion for health and social care.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard people they supported.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff understood when an application should be made and in how to submit one. We saw best interest meetings had been held when necessary and these were clearly recorded. The records confirmed safeguarding procedures had been followed and the people had received appropriate support and representation during the meetings. This meant people�s rights were safely protected.

The service was safe, clean and hygienic. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. People living at the home told us they were happy and well looked after.

We looked at the recruitment of new staff. This showed that some required recruitment checks had not been undertaken. We found gaps in employment history were not being explored at interview. This meant the home did not have a full employment history of the people employed.

People did not always receive their medicines at the times they needed them and in a safe way. Medicines were not always administered and recorded properly. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to recruiting new staff and administration of medicines.

Is the service effective?

People�s health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were happy with the care being provided. One person said, �I love it here. The girls really look after us. They are so pleasant and caring. Nothing is too much trouble for them. The food is wonderful and we have lots of activities to keep us entertained.� Two people visiting their relatives told us they were happy with the home and had no concerns about the care provided. One person said, �I cannot believe the difference in my mum since she moved into the home. She is always clean and well presented. How they manage it I don�t know. The staff really care. I cannot praise them high enough.� Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

Records showed admissions to the home were well planned. Information about people�s care and dietary needs had been recorded. We also saw potential risks to people�s health and welfare had been identified. Guidance had been provided for staff to ensure they provided safe and appropriate care. We found people completed a range of activities. On the day of our inspection we saw people playing dominoes and bingo in the afternoon. People we spoke with said they enjoyed the activities organised by the home. We found people had access to healthcare professionals. People received regular health checks with their General Practitioner and the outcome of these visits were recorded on their care records.

Is the service well-led?

The service had quality assurance systems in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.

Inspection carried out on 8 April 2013

During a routine inspection

During our inspection we looked at care and staff training records, staff supervision arrangements and undertook a tour of the building. We also spoke with visiting relatives, people staying at the home, two staff members, the manager and registered provider. Care practices were also observed throughout the inspection. We did this to confirm people were having their care needs met. We also wanted to identify that appropriate arrangements were in place to support staff members.

The people we spoke with said they were receiving safe and appropriate care. They told us the staff were polite, caring and professional when undertaking their work. One person said, �The staff have been very caring and attentive during my stay. I would recommend this home to anyone�. A visiting relative told us they were very happy with the care being provided. They said, �I looked around a number of homes before choosing this one. I picked it because I felt I could stay here myself. The care has been outstanding and my mum tells me she is very happy. I always feel very welcome whenever I visit. I have no concerns about her care�.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

Inspection carried out on 19 October 2012

During a routine inspection

We spoke with two people living at Feng Shui House. They told us they were happy with the support they received and they were able to make decisions about how they spent their day. Comments included, �I am able to come and go as I please�, �It�s a lovely place� and �We can do what we want�. They also told us they were able to express their views and opinions of the service.

We found the people living at the home did not have appropriate recorded information in relation to their care, support and treatment. This meant staff may not know how to look after people properly or be able to provide the care and support people needed and wanted.

We observed staff interacting with people in a pleasant and friendly manner and being respectful of people's choices and opinions. One person living at the home said, "The staff are very nice�.